Melanoma

Melanoma experts at Duke use the latest medical and surgical advances to detect melanoma at the earliest stage, and treat the skin cancer quickly and effectively. Our involvement in clinical trials offers hope to advanced melanoma patients, as well as patients at high risk for recurrent melanoma. Your personalized treatment plan ensures you experience the best results possible for your condition.

Leaders in Melanoma Treatment, Care and Research

Melanoma is a curable cancer if it is caught early and treated effectively. Later stages of the cancer must be treated aggressively to control its spread and minimize the risk that it will return. If you have already been diagnosed with melanoma and need care, our team of specialists have every diagnostic, medical and surgical tool at their fingertips, and the advanced training to achieve the best possible results. Since we are a melanoma research center, you may be eligible to participate in our clinical trials, which are studying several new therapies for advanced melanoma patients, as well as patients at risk for recurrent melanoma. Our work is showing promise for extending survival and achieving better outcomes.

A team approach. Our melanoma team includes dermatologists, medical oncologists, surgical oncologists, radiation oncologists, otolaryngologists (ear, nose and throat doctors), dermatopathologists (specialists who look at skin diseases at a cellular level), and radiologists, who work together to develop the most effective treatment plan for you.

Leaders in regional chemotherapy. We are a major referral center for regional chemotherapy, which is given in high doses to people whose melanoma has recurred in multiple places along an arm or leg.

Access to clinical trials. Depending on the stage and type of your melanoma, you may be eligible to participate in our numerous clinical trials, which are studying new therapies, and therapy combinations. Our goal is to develop new ways to extend survival and improve outcomes in advanced melanoma patients, as well as patients who are at high risk for recurrent melanoma. Many of these therapies are offering hope and showing promise to people who are no longer candidates for surgery.

Expertise in head and neck melanoma. Our experienced ear, nose and throat surgeons are specially trained in removing melanoma that involves the head and neck. Their expertise working exclusively on the head and neck increases the likelihood that you will experience a positive outcome for these complicated procedures.

Ocular melanoma treatment options. Our ophthalmologists are specially trained to detect and treat melanoma that occurs around or near the eye. Treatments, including chemotherapy, radiation and surgery, are personalized to your individual tumor location, stage and type.

Compassionate care for pediatric melanoma. If your child has been diagnosed with melanoma, we make the treatment process as smooth and compassionate as possible. Appointments with your oncologist and dermatologist can be conveniently scheduled at the same time and location, and a child life specialist is present to ensure your child feels as comfortable as possible.

Comprehensive support. You’ll have access to our many cancer support services which help you understand and make decisions about treatment options, manage the side effects of your melanoma treatment, and help you and your family cope with the emotional effects of your diagnosis and treatment. View all of our cancer support groups in our event calendar.

MELANOMA
Treatments

Your doctor will develop your treatment plan based on the location of your melanoma, how deeply it has penetrated the surface of your skin, and whether it has spread to other parts of your body. Treatment options for melanoma include:

Surgery

Removes the tumor and surrounding normal tissue. Surgery may be the only treatment necessary for small melanomas that are detected early. When larger tumors are present, it may be combined with a lymph node dissection.

Lymph Node Dissection

Removes lymph nodes when melanoma has spread. Your doctor may perform a sentinel node biopsy, in which the lymph node located closest to the tumor is removed and examined for cancer. If cancer free, no additional lymph nodes are removed.

Mohs Surgery

Layers of melanoma are surgically removed and examined under a microscope to ensure all cancer has been removed. Used in select cases of melanoma that are detected early.

Chemotherapy

Kills or halts the growth of cancerous cells. Chemotherapy is used in select cases of advanced melanoma when surgery is not an option.

Regional Chemotherapy

If multiple melanomas are confirmed to an arm or leg, our surgical oncologists may perform this surgical procedure in which high doses of regional chemotherapy are delivered directly to the affected region, while minimizing exposure to the rest of the body. We are a nationally recognized referral center for this type of regional chemotherapy.

Immunotherapy

Given intravenously to boost the body’s immune system, and help it identify and destroy the melanoma. We use a variety of immunotherapies to prevent recurrence, and in advanced melanoma patients who are not candidates for surgery. You may also be able to participate in our clinical trials which are evaluating whether combinations of these therapies with other medications may extend survival or boost the drugs’ ability to attack melanoma more effectively.

Targeted Therapy

Targets proteins in the BRAF gene, which is linked to nearly half of all melanoma. Changes in the BRAF gene create a protein that causes melanoma to grow and divide. Some of the targeted therapies, such as vemurafenib and dabrafenib, block the BRAF protein. Targeted therapy may also target other genes known to affect melanoma cancer growth. Your tumor’s genetic make-up will determine if you are eligible for these targeted therapies. You may also be eligible to participate in clinical trials investigating recently developed targeted therapies not widely available or FDA-approved.

Radiation Therapy

X-rays destroy cancer cells or shrink tumors. May be used with surgery to prevent cancer from recurring, or to treat cancer that has spread.

Skin Grafting and Reconstructive Surgery

A skin graft from another part of your body is used to cover wounds, promote healing and restore the skin’s appearance.

MELANOMA
Tests

Physical Exam

Melanoma is typically first identified during a physical exam. A dermatologist may use a high-powered microscope called a dermatoscope to examine the site more closely.

Total Body Photography

If you have several moles on your body, or a family history of melanoma, our dermatologists may use mole-mapping technology to take sequential photographs of your body from multiple angles. The photographs allow your dermatologist to track changes in your skin and evaluate your melanoma risk over time.

Biopsy

If melanoma is suspected, a sample of skin will be removed and examined for the presence of cancer. The type of biopsy you undergo will be determined by how deep into your skin your physician believes the melanoma has penetrated. A shave biopsy takes less skin, while a punch biopsy removes a deeper portion of skin.

Surgical Biopsy

Removes a much larger section of skin including the melanoma and surrounding tissue to confirm the diagnosis and stage the cancer. This technique can also be used to ensure that the cancer has been completely removed. A lymph node biopsy may be performed to determine if melanoma has spread to the lymph nodes.